EU EHEALTH INTEROPERABILITY, STANDARDIZATION AND DEPLOYMENT STRATEGY

Benoit Abeloos, Standardization and InteroperabilityDG CNECT, Health and Wellbeing Unit

Workshop on Sensor Communications & Technologies, BAN, e-Health Services and Standardization

4 April 2014

• Directive on the application of patients’ rights in cross-border healthcare

• Regulation on European Standardization• Digital Agenda for Europe:

• Action 75: Give Europeans secure online access to their medical health data and achieve widespread telemedicine deployment

• Action 76: Propose a recommendation to define a minimum common set of patient data

• Action 77: Foster EU-wide standards, interoperability testing and certification of eHealth

• eHealth Action Plan• Achieving wider interoperability of eHealth Services• Facilitating uptake and ensuring wider deployment of eHealth

• European Innovation Partnership in Active and Healthy Ageing• Medical Devices Directive, being revised

Policy drivers

Towards a single digital market in 2020

Source: Digital Agenda for Europe (http://ec.europa.eu/information_society/digital-agenda/ )

eHealth Governance

• The eHealth Network:• Article 14 of Directive on the application of patients’

rights in cross-border healthcare• Voluntary network of national authorities in charge

of eHealth to• Cooperate on sustainable economic and social benefits of European eHealth

systems (interoperability, trust and security, quality & continuity of care, patient safety)

• Draw up guidelines on Patient Summary (adopted Nov 2014) and ePrescription• Develop eID and authentication measures

• eHealth Governance initiative• Prepares the work for the eHealth Network• Experts, multi stakeholders, focused on MS

• eHealth Stakeholders' Group• SDOs, patients, health care providers, SMEs,

industry,…

European Innovation Partnership on Active & Healthy Ageing

The first attempt to bring together interested parties from public and private sectors to deliver innovative solutions for an ageing society

The first attempt to bring together interested parties from public and private sectors to deliver innovative solutions for an ageing society

What?What?

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EIP-AHA: Public Consultation

Standards uptake is key...

Standardization regulation and MSP

• Establishes the ICT standards multi-stakeholders platform composed of• Member states – min in charge of standards• ESO – CEN, CENELEC, ETSI• International SDOs: ISO, IEC, ITU• De facto SDOs: OASIS, IEEE, IETF, W3C, GS1, ECMA,

OMG…• Consortia: Digital Europe, OpenForumEurope,…

• Advises on identification of ICT technical specifications• Based on criteria in annex II of the regulation:

• Openness, Transparency, Consensus, • Maintenance, availability, IPR, relevance, neutrality and

stability, quality

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Interoperability Levels

Pri

nci

ple

s

Inte

ropera

bili

ty

Agre

em

ents

Governance

Legal Interoperability

Legal Interoperability

Organisational InteroperabilityOrganisational Interoperability

Semantic Interoperability

Semantic Interoperability

Technical Interoperability

Technical Interoperability

Achieving wider interoperability of eHealth services

The eHealth Interoperability Framework was defined in a study (http://ec.europa.eu/digital-agenda/en/news/ehealth-interoperability-framework-study-0)

Instruments

• Standardization Mandates with EU SDOs• H2020 Work Program–eHealth Interoperability-PHC34• Connecting Europe Facility

• Large scale deployment of interoperable cross border services

• eHealth in 2015

• Identification of technical specifications• eHEIF study• Submission of IHE specifications – ongoing

EU Cross-Border eHealth Interoperability ProjectEU Cross-Border eHealth Interoperability Project

Profile 1

Profile 1

Profile 2

Profile 2

Profile 4

Profile 4

Vision of eHealth EIF

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International base standards and profile development

Base Standard 1

Base Standard 1

Base Standard 2

Base Standard 2

Base Standard 3

Base Standard 3

Base Standard 4

Base Standard 4

Base Standard 5

Base Standard 5

Profile 1Profile 1

Profile 2Profile 2

Profile 4Profile 4

Profile 3Profile 3

eHealth European Interoperability Framework: EU Recognised profileseHealth European Interoperability Framework: EU Recognised profiles

B-Use Case

A

B-Use Case

A

B-Use Case

B

B-Use Case

B

Profile 1

Profile 1

Profile 2

Profile 2

Profile 4

Profile 4

Profile 1

Profile 1

Profile 3

Profile 3

Profile 4

Profile 4

Profile 1

Profile 1

Profile 2

Profile 2

Profile 4

Profile 4

B-Use Case A1

B-Use Case A1

B-Use Case A1

B-Use Case A1

Specific

Profile

Specific

Profile

(Extensions)(Extensions)

National/Regional eHealth Interoperability ProjectNational/Regional eHealth Interoperability Project

Profile 1

Profile 1

Profile 2

Profile 2

Profile 4

Profile 4

Profile 1

Profile 1

Profile 2

Profile 2

Profile 4

Profile 4

B-Use Case A1

B-Use Case A1

B-Use Case A2

B-Use Case A2

Specific

Profile

Specific

Profile

(Extensions)(Extensions)

Local (e.g. Hospital) eHealth Interoperability ProjectLocal (e.g. Hospital) eHealth Interoperability Project

Profile 1

Profile 1

Profile 2Profile 2

Profile 4

Profile 4

Profile 1

Profile 1

Profile 2

Profile 2

Profile 4

Profile 4

B-Use Case A1

B-Use Case A1

B-Use Case B1

B-Use Case B1

Specific

Profile

Specific

Profile

(Extensions)(Extensions)

(Note: B-Use Case = Business Use Case)

The 10 initial use cases

Citizens at home & on the move

- PC-based Care Mgt.

- Mobile-basedCare Mgt.

- Sensor-based Care Mgt.

UC 8

UC 9

UC 10

- Hospital IIIa

- Hospital IIIb

RIS LIS

RIS LIS

(2 hospital locationsaffiliated to same

hospital mgt. organization)

UC 6 UC 7

UC 3 + UC 4

National / Regional Level

Cross-border Level

- Primary care physician

- Hospital I

Medical care provision

- Pharmacy

- Medical Specialist

- Rehabilitation

UC 2a/ 2b

Inpatient medical care provision

- Hospital II

- Medical Specialist

- Rehabilitation

UC 1Medical care provision

- Pharmacy

UC 5b

UC 5a- Primary care physician

The EIF is a process

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Review by eHealth

Governance Initiative

Review &

decision by

eHealth Network

Update of eHealth

EIF

Acerta’sData

GovernanceFramework

New insights

Receiving feedback

eHealth EIF project

eHealth EIF project

Ongoing initiatives

• epSOS• Large scale pilot – 13 nations piloting• Ends in June 2014• Interoperability Framework based on international

standards and IHE profiles• Extensions for cross border exchange of health data (IHE)• Published open source components

• EXPAND• eHealth Governance Initiative• eHR4CR – IMI – Conference on April 9• SemanticHelathNet – NoE• Discussions with IHTSDO for the use of SNOMED

The Antilope project

• Refining the eHealth Interoperability Framework• Further defining the high level use cases

• Adoption and take up of standards and profiles for eHealth Interoperability (DAE action 77)

• Main target dissemination target: procurers and (consequently) vendors

• Defining a quality assurance model for interoperability testing

• Identifying and addressing gaps in testing tools• Defining an IOp Label and certification process• Validating scalability to EIP and adoption

• A MoU (signed in Dec 2010 by EC VP N. Kroes and US Secretary of Health K. Sebelius) aims to foster a mutual understanding of the common challenges

• The Trans-Atlantic Economic Council (TEC) of Nov. 2011 reinforced commitment to the MoU

• Two issues identified of having immediate importance:• Development of international interoperability standards and specifications for

eHR• Strategies for development of skilled health IT workforces

• A commonly agreed roadmap was published on 20 June 2013 – it needs to be updated

• eHealth Forum 2014, Athens, May 12-14: EU-US workshop• The Trillium Bridge (www.trilliumbridge.eu) project is supporting this effort• End result could be a standardization project

The EU-US roadmap and the Trillium Bridge project

Thank you!

• ec.europa.eu/digital-agenda/ehealth

@EU_ehealth@EU_ehealthweek

EU.ehealthEhealthweek.eu

• Benoit Abeloos: benoit.abeloos@ec.europa.eu